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A simplified biventricular defibrillator with fixed long detection intervals reduces implantable cardioverter defibrillator (ICD) interventions and heart failure hospitalizations in patients with non-ischaemic cardiomyopathy implanted for primary prevention: the RELEVANT [Role of long dEtection window programming in patients with LEft VentriculAr dysfunction, Non-ischemic eTiology in primary prevention treated with a biventricular ICD] study
Gasparini M et al. – A simplified cardioverter–defibrillator (CRT-D) device with fixed long detection reduced overall implantable cardioverter defibrillator (ICD) therapy burden and heart failure (HF) hospitalizations without entailing any additional adverse events in primary prevention non-ischemic HF pts.

Methods

  • Study of the efficacy and safety of a cardiac resynchronization therapy with CRT-D device with simplified ventricular tachycardia management in pts with non-ischemic HF and primary prevention ICD indication
  • Prospective, controlled, parallel, multi-center, non-randomized study enrolling 324 primary prevention non-ischemic HF pts implanted with CRT-D devices from 2004-2007
  • Protect group: 164 pts implanted with Medtronic Insync III Protect device
  • Control group: 160 pts using other Medtronic CRT-D devices
  • Efficacy assessment by computing appropriate and inappropriate detections and therapies during follow-up
  • Safety assessment by comparing hospitalizations and syncopal events between groups

Results
  • With the Protect algorithm, 90% of both ventricular and supraventricular tachyarrhythmias terminated within 13–29 beat detection interval
  • Protect group had significantly better event-free survival to first delivered therapy for total, appropriately treated, and inappropriately treated episodes
  • Total number of delivered shocks significantly lower in Protect group (22 vs 59)
  • In Protect group, significantly reduced HF hospitalization without any increase of syncope or death
[more...]
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